Form SS-8 Form SS-8 Determination of Worker Status for Purposes of Federal E

Form

SS-8

(Rev. August 2011)
Department of the Treasury
Internal Revenue Service

OMB. No. 1545-0004

Determination of Worker Status for Purposes
of Federal Employment Taxes and
Income Tax Withholding

For IRS Use Only:
Case Number:
Earliest Receipt Date:

Name of firm (or person) for whom the worker performed services

Worker’s name

Firm’s mailing address (include street address, apt. or suite no., city, state, and ZIP code)

Worker’s mailing address (include street address, apt. or suite no., city, state, and ZIP code)

Trade name

Firm's email address

Worker's daytime telephone number

Worker's email address

Firm's fax number

Firm's website

Worker's alternate telephone number

Worker's fax number

Firm's telephone number (include area code)

Firm’s employer identification number

Worker’s social security number

Worker’s employer identification number (if any)

Note. If the worker is paid for these services by a firm other than the one listed on this form, enter the name, address, and employer identification
number of the payer. ▶

Disclosure of Information
The information provided on Form SS-8 may be disclosed to the firm, worker, or payer named above to assist the IRS in the determination process.
For example, if you are a worker, we may disclose the information you provide on Form SS-8 to the firm or payer named above. The information can
only be disclosed to assist with the determination process. If you provide incomplete information, we may not be able to process your request. See
Privacy Act and Paperwork Reduction Act Notice on page 6 for more information. If you do not want this information disclosed to other parties, do
not file Form SS-8.
Parts I–V. All filers of Form SS-8 must complete all questions in Parts I–IV. Part V must be completed if the worker provides a service directly to
customers or is a salesperson. If you cannot answer a question, enter “Unknown” or “Does not apply.” If you need more space for a question, attach
another sheet with the part and question number clearly identified. Write your firm's name (or workers' name) and employer identification number (or
social security number) at the top of each additional sheet attached to this form.

Part I
1

General Information

This form is being completed by:

Firm

Worker; for services performed

to
(beginning date)

.
(ending date)

2

Explain your reason(s) for filing this form (for example, you received a bill from the IRS, you believe you erroneously received a Form 1099 or
Form W-2, you are unable to get worker’s compensation benefits, or you were audited or are being audited by the IRS).

3
4

Total number of workers who performed or are performing the same or similar services:
Application
Bid
Employment Agency
How did the worker obtain the job?

5

Attach copies of all supporting documentation (for example, contracts, invoices, memos, Forms W-2 or Forms 1099-MISC issued or received, IRS
closing agreements or IRS rulings). In addition, please inform us of any current or past litigation concerning the worker’s status. If no income reporting forms
.
(Form 1099-MISC or W-2) were furnished to the worker, enter the amount of income earned for the year(s) at issue $

.
Other (specify)

If both Form W-2 and Form 1099-MISC were issued or received, explain why.
6

Describe the firm’s business.

For Privacy Act and Paperwork Reduction Act Notice, see page 6.

Cat. No. 16106T

Form SS-8 (Rev. 8-2011)

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Form SS-8 (Rev. 8-2011)

Part I
7

General Information (continued)

If the worker received pay from more than one entity because of an event such as the sale, merger, acquisition, or reorganization of the firm for
whom the services are performed, provide the following: Name of the firm's previous owner:
Previous owner's taxpayer identification number:
Other (specify)
Description of above change:

Change was a:

8

Date of change (MM/DD/YY):
Describe the work done by the worker and provide the worker’s job title.

9

Explain why you believe the worker is an employee or an independent contractor.

10

Sale

Merger

Acquisition

Reorganization

Did the worker perform services for the firm in any capacity before providing the services that are the subject of this determination request?
Yes
No
N/A
If “Yes,” what were the dates of the prior service?
If “Yes,” explain the differences, if any, between the current and prior service.

11

If the work is done under a written agreement between the firm and the worker, attach a copy (preferably signed by both parties). Describe the
terms and conditions of the work arrangement.

Part II

Behavioral Control (Provide names and titles of specific individuals, if applicable.)

1

What specific training and/or instruction is the worker given by the firm?

2

How does the worker receive work assignments?

3

Who determines the methods by which the assignments are performed?

4

Who is the worker required to contact if problems or complaints arise and who is responsible for their resolution?

5

What types of reports are required from the worker? Attach examples.

6

Describe the worker’s daily routine such as his or her schedule or hours.

7

At what location(s) does the worker perform services (for example, firm’s premises, own shop or office, home, customer’s location)? Indicate
the appropriate percentage of time the worker spends in each location, if more than one.

8

Describe any meetings the worker is required to attend and any penalties for not attending (for example, sales meetings, monthly meetings,
staff meetings).

9
10
11

Is the worker required to provide the services personally? . . .
If substitutes or helpers are needed, who hires them?
If the worker hires the substitutes or helpers, is approval required?
If “Yes,” by whom?

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Yes

No

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Yes

No

12
13

Who pays the substitutes or helpers?
Is the worker reimbursed if the worker pays the substitutes or helpers? .
If “Yes,” by whom?

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Yes

No

Form SS-8 (Rev. 8-2011)

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Form SS-8 (Rev. 8-2011)

Part III
1

Financial Control (Provide names and titles of specific individuals, if applicable.)

List the supplies, equipment, materials, and property provided by each party:
The firm:
The worker:

2

Other party:
Does the worker lease equipment, space, or a facility? . . . . . . . . .
If “Yes,” what are the terms of the lease? (Attach a copy or explanatory statement.)

3

What expenses are incurred by the worker in the performance of services for the firm?

4

Specify which, if any, expenses are reimbursed by:
The firm:
Other party:

5

Type of pay the worker receives:
Salary
Commission
Hourly Wage
Lump Sum
Other (specify)
If type of pay is commission, and the firm guarantees a minimum amount of pay, specify amount. $

6

Is the worker allowed a drawing account for advances?
If “Yes,” how often?
Specify any restrictions.

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7

Whom does the customer pay? . . . . . . . . .
If worker, does the worker pay the total amount to the firm?

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Yes

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Firm
. . .
No If “No,” explain.

8
9

Does the firm carry workers' compensation insurance on the worker?
. . . . . . . . . . . . . . .
Yes
No
What economic loss or financial risk, if any, can the worker incur beyond the normal loss of salary (for example, loss or damage of equipment,
material)?

10

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Does the worker establish the level of payment for the services provided or the products sold? .
If “No,” who does?

Part IV
1

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Yes

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No

Piece Work

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Yes

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No

Worker

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Yes

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No

Relationship of the Worker and Firm

Please check the benefits available to the worker:
Paid vacations
Pensions
Personal days
Other (specify)

Sick pay

Paid holidays
Bonuses

Insurance benefits

2

Can the relationship be terminated by either party without incurring liability or penalty?
If “No,” explain your answer.

3

Did the worker perform similar services for others during the time period entered in Part I, line 1? . . . . . . .
Yes
No
Yes
No
If “Yes,” is the worker required to get approval from the firm? . . . . . . . . . . . . . . . . . .
Describe any agreements prohibiting competition between the worker and the firm while the worker is performing services or during any later
period. Attach any available documentation.

4

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Yes

5
6

Is the worker a member of a union?
. . . . . . . . . . . . . . . . . . . . . . . . .
Yes
What type of advertising, if any, does the worker do (for example, a business listing in a directory or business cards)? Provide copies, if
applicable.

7

If the worker assembles or processes a product at home, who provides the materials and instructions or pattern?

8

What does the worker do with the finished product (for example, return it to the firm, provide it to another party, or sell it)?

9

How does the firm represent the worker to its customers (for example, employee, partner, representative, or contractor), and under whose
business name does the worker perform these services?

10

No

No

If the worker no longer performs services for the firm, how did the relationship end (for example, worker quit or was fired, job completed,
contract ended, firm or worker went out of business)?
Form SS-8 (Rev. 8-2011)

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Form SS-8 (Rev. 8-2011)

Part V

For Service Providers or Salespersons. Complete this part if the worker provided a service directly to
customers or is a salesperson.

1

What are the worker’s responsibilities in soliciting new customers?

2
3

Who provides the worker with leads to prospective customers?
Describe any reporting requirements pertaining to the leads.

4
5
6

What terms and conditions of sale, if any, are required by the firm?
Are orders submitted to and subject to approval by the firm? . .
Who determines the worker’s territory?

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Yes

No

7

Did the worker pay for the privilege of serving customers on the route or in the territory? .
If “Yes,” whom did the worker pay?
If “Yes,” how much did the worker pay? . . . . . . . . . . . . . . .

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Yes

No

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8

Where does the worker sell the product (for example, in a home, retail establishment)?

9

List the product and/or services distributed by the worker (for example, meat, vegetables, fruit, bakery products, beverages, or laundry or dry
cleaning services). If more than one type of product and/or service is distributed, specify the principal one.

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10

Does the worker sell life insurance full time? .

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Yes

No

11

Does the worker sell other types of insurance for the firm? .

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Yes

No
%

12

If “Yes,” enter the percentage of the worker’s total working time spent in selling other types of insurance . . . . .
If the worker solicits orders from wholesalers, retailers, contractors, or operators of hotels, restaurants, or other similar
establishments, enter the percentage of the worker’s time spent in the solicitation . . . . . . . . . . . .
Yes

No

13

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Is the merchandise purchased by the customers for resale or use in their business operations? . .
Describe the merchandise and state whether it is equipment installed on the customers’ premises.

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Under penalties of perjury, I declare that I have examined this request, including accompanying documents, and to the best of my knowledge and belief, the
facts presented are true, correct, and complete.

▲

Sign
Here

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Title

▶

Date

▶

Type or print name below signature.
Form SS-8 (Rev. 8-2011)

Page 5

Form SS-8 (Rev. 8-2011)

General Instructions

Completing Form SS-8

Section references are to the Internal Revenue Code unless
otherwise noted.

Answer all questions as completely as possible. Attach
additional sheets if you need more space. Provide information
for all years the worker provided services for the firm.
Determinations are based on the entire relationship between the
firm and the worker. Also indicate if there were any significant
changes in the work relationship over the service term.

Purpose
Firms and workers file Form SS-8 to request a determination of
the status of a worker for purposes of federal employment taxes
and income tax withholding.
A Form SS-8 determination may be requested only in order to
resolve federal tax matters. If Form SS-8 is submitted for a tax
year for which the statute of limitations on the tax return has
expired, a determination letter will not be issued. The statute of
limitations expires 3 years from the due date of the tax return or
the date filed, whichever is later.
The IRS does not issue a determination letter for proposed
transactions or on hypothetical situations. We may, however,
issue an information letter when it is considered appropriate.

Definition
Firm. For the purposes of this form, the term “firm” means any
individual, business enterprise, organization, state, or other
entity for which a worker has performed services. The firm may
or may not have paid the worker directly for these services.
If the firm was not responsible for payment for
services, be sure to enter the name, address, and
employer identification number of the payer on the
CAUTION
first page of Form SS-8, below the identifying
information for the firm and the worker.

!
▲

The Form SS-8 Determination Process
The IRS will acknowledge the receipt of your Form SS-8.
Because there are usually two (or more) parties who could be
affected by a determination of employment status, the IRS
attempts to get information from all parties involved by sending
those parties blank Forms SS-8 for completion. Some or all of
the information provided on this Form SS-8 may be shared with
the other parties listed on page 1. The case will be assigned to a
technician who will review the facts, apply the law, and render a
decision. The technician may ask for additional information from
the requestor, from other involved parties, or from third parties
that could help clarify the work relationship before rendering a
decision. The IRS will generally issue a formal determination to
the firm or payer (if that is a different entity), and will send a
copy to the worker. A determination letter applies only to a
worker (or a class of workers) requesting it, and the decision is
binding on the IRS. In certain cases, a formal determination will
not be issued. Instead, an information letter may be issued.
Although an information letter is advisory only and is not binding
on the IRS, it may be used to assist the worker to fulfill his or her
federal tax obligations.
Neither the Form SS-8 determination process nor the review
of any records in connection with the determination constitutes
an examination (audit) of any federal tax return. If the periods
under consideration have previously been examined, the Form
SS-8 determination process will not constitute a reexamination
under IRS reopening procedures. Because this is not an
examination of any federal tax return, the appeal rights available
in connection with an examination do not apply to a Form SS-8
determination. However, if you disagree with a determination or
you have additional information concerning the work
relationship that you believe was not previously considered, you
may request that the determining office reconsider the
determination.

Additional copies of this form may be obtained on IRS.gov or
by calling 1-800-TAX-FORM (1-800-829-3676).

Fee
There is no fee for requesting a Form SS-8 determination letter.

Signature
Form SS-8 must be signed and dated by the taxpayer. A
stamped signature will not be accepted.
The person who signs for a corporation must be an officer of
the corporation who has personal knowledge of the facts. If the
corporation is a member of an affiliated group filing a
consolidated return, it must be signed by an officer of the
common parent of the group.
The person signing for a trust, partnership, or limited liability
company must be, respectively, a trustee, general partner, or
member-manager who has personal knowledge of the facts.

Where To File
Send the completed and signed Form SS-8 to the address
below for the firm's location. Faxed, photocopied, or electronic
versions of Form SS-8 are not acceptable for the initial request
for the Form SS-8 determination. However, only for cases
involving federal agencies, send Form SS-8 to the Internal
Revenue Service, Attn: CC:CORP:T:C, Ben Franklin Station,
P.O. Box 7604, Washington, DC 20044. Do not submit Form
SS-8 with your tax return as that will delay processing time.

Firm’s location:

Send to:

Alaska, Arizona, Arkansas,
California, Colorado, Hawaii,
Idaho, Illinois, Iowa, Kansas,
Minnesota, Missouri, Montana,
Nebraska, Nevada, New
Mexico, North Dakota,
Oklahoma, Oregon, South
Dakota, Texas, Utah,
Washington, Wisconsin,
Wyoming, American Samoa,
Guam, Puerto Rico, U.S. Virgin
Islands

Internal Revenue Service
Form SS-8 Determinations
P.O. Box 630
Stop 631
Holtsville, NY 11742-0630

Alabama, Connecticut,
Delaware, District of Columbia,
Florida, Georgia, Indiana,
Kentucky, Louisiana, Maine,
Maryland, Massachusetts,
Michigan, Mississippi, New
Hampshire, New Jersey, New
York, North Carolina, Ohio,
Pennsylvania, Rhode Island,
South Carolina, Tennessee,
Vermont, Virginia, West Virginia,
all other locations not listed

Internal Revenue Service
Form SS-8 Determinations
40 Lakemont Road
Newport, VT 05855-1555

Form SS-8 (Rev. 8-2011)

Form SS-8 (Rev. 8-2011)

Instructions for Workers
If you are requesting a determination for more than one firm,
complete a separate Form SS-8 for each firm.
Form SS-8 is not a claim for refund of social security
and Medicare taxes or federal income tax
withholding.

!
▲
CAUTION

If the IRS determines that you are an employee, you are
responsible for filing an amended return for any corrections
related to this decision. A determination that a worker is an
employee does not necessarily reduce any current or prior tax
liability. For more information, call 1-800-829-1040.
Time for filing a claim for refund. Generally, you must file your
claim for a credit or refund within 3 years from the date your
original return was filed or within 2 years from the date the tax
was paid, whichever is later.
Filing Form SS-8 does not prevent the expiration of the time
in which a claim for a refund must be filed. If you are
concerned about a refund, and the statute of limitations for filing
a claim for refund for the year(s) at issue has not yet expired,
you should file Form 1040X, Amended U.S. Individual Income
Tax Return, to protect your statute of limitations. File a separate
Form 1040X for each year.
On the Form 1040X you file, do not complete lines 1 through
22 on the form. Write “Protective Claim” at the top of the form,
sign and date it. In addition, enter the following statement in
Part III: “Filed Form SS-8 with the Internal Revenue Service
Office in (Holtsville, NY; Newport, VT; or Washington, DC; as
appropriate). By filing this protective claim, I reserve the right to
file a claim for any refund that may be due after a determination
of my employment tax status has been completed.”
Filing Form SS-8 does not alter the requirement to timely file
an income tax return. Do not delay filing your tax return in
anticipation of an answer to your Form SS-8 request. In
addition, if applicable, do not delay in responding to a request
for payment while waiting for a determination of your worker
status.

Instructions for Firms
If a worker has requested a determination of his or her status
while working for you, you will receive a request from the IRS to
complete a Form SS-8. In cases of this type, the IRS usually
gives each party an opportunity to present a statement of the
facts because any decision will affect the employment tax
status of the parties. Failure to respond to this request will not
prevent the IRS from issuing a determination letter based on the
information he or she has made available so that the worker
may fulfill his or her federal tax obligations. However, the
information that you provide is extremely valuable in
determining the status of the worker.
If you are requesting a determination for a particular class of
worker, complete the form for one individual who is
representative of the class of workers whose status is in
question. If you want a written determination for more than one
class of workers, complete a separate Form SS-8 for one
worker from each class whose status is typical of that class. A
written determination for any worker will apply to other workers
of the same class if the facts are not materially different for
these workers. Please provide a list of names and addresses of
all workers potentially affected by this determination.

Page 6

If you have a reasonable basis for not treating a worker as an
employee, you may be relieved from having to pay employment
taxes for that worker under section 530 of the 1978 Revenue
Act. However, this relief provision cannot be considered in
conjunction with a Form SS-8 determination because the
determination does not constitute an examination of any tax
return. For more information regarding section 530 of the 1978
Revenue Act and to determine if you qualify for relief under this
section, visit IRS.gov.
Privacy Act and Paperwork Reduction Act Notice. We ask for
the information on Form SS-8 to carry out the Internal Revenue
laws of the United States. This information will be used to
determine the employment status of the worker(s) described on
the form. Subtitle C, Employment Taxes, of the Internal Revenue
Code imposes employment taxes on wages, including income
tax withholding. Sections 3121(d), 3306(a), and 3401(c) and (d)
and the related regulations define employee and employer for
purposes of employment taxes imposed under Subtitle C.
Section 6001 authorizes the IRS to request information needed
to determine if a worker(s) or firm is subject to these taxes.
Section 6109 requires you to provide your taxpayer
identification number. Neither workers nor firms are required to
request a status determination, but if you choose to do so, you
must provide the information requested on this form. Failure to
provide the requested information may prevent us from making
a status determination. If any worker or the firm has requested a
status determination and you are being asked to provide
information for use in that determination, you are not required to
provide the requested information. However, failure to provide
such information will prevent the IRS from considering it in
making the status determination. Providing false or fraudulent
information may subject you to penalties. Generally, tax returns
and return information are confidential, as required by section
6103. However, section 6103 allows or requires the IRS to
disclose or give the information shown on your tax return to
others as described in the Code. Routine uses of this
information include providing it to the Department of Justice for
use in civil and criminal litigation, to the Social Security
Administration for the administration of social security
programs, and to cities, states, the District of Columbia, and
U.S. commonwealths and possessions for the administration of
their tax laws. We also may disclose this information to other
countries under a tax treaty, to federal and state agencies to
enforce federal nontax criminal laws, or to federal law
enforcement and intelligence agencies to combat terrorism. We
may provide this information to the affected worker(s), the firm,
or payer as part of the status determination process.
You are not required to provide the information requested on
a form that is subject to the Paperwork Reduction Act unless
the form displays a valid OMB control number. Books or
records relating to a form or its instructions must be retained as
long as their contents may become material in the
administration of any Internal Revenue law.
The time needed to complete and file this Form SS-8 will vary
depending on individual circumstances. The estimated average
time is: Recordkeeping, 23 hrs., 55 min.; Learning about the law
or the form, 1 hr., 48 min.; Preparing the form, 5 hrs., 03 min.;
and Sending the form to the IRS, 48 min. If you have comments
concerning the accuracy of these time estimates or suggestions
for making this form simpler, we would be happy to hear from
you. You can write to the Internal Revenue Service, Tax
Products Coordinating Committee, SE:W:CAR:MP:T:M:S,
1111 Constitution Ave. NW, IR-6526, Washington, DC 20224.
Do not send the tax form to this address. Instead, see Where To
File on page 5.